A configurable coil arrangement for use with MRI-guided procedures is provided that facilitates optimal imaging for both pre-procedure planning and imaging of the target sites during the procedure. The coil arrangement includes a plurality of connected coil elements. Spacers connecting the coil elements can be adjustable and/or deformable to provide one or more openings in the coil arrangement of optimal size for accessing the subject within the imaged region. Individual coil elements can also be removed to provide access openings during such procedures, or left in the array for improved pre- and post-procedure image quality. The MRI system can be configured to detect configurations of the coil arrangement and modify imaging parameters to optimize image quality.